A Health Reform Agenda for Black America

As the Equity act suggests, access to care won’t fix everything. The landmark Unequal Treatment report from the Institute of Medicine documented that even with comparable insurance coverage, income and education levels, blacks and other people of color receive lower quality care.

From cardiac care to kidney dialysis, minorities receive unequal treatment. National standards for data collection are needed to track and target programs and resources to address these disparities. Comprehensive health reform has to include mandates for improving quality and data collection and reporting on race, ethnicity and gender in the health care system.

Whether intentional or not, provider bias is real. Physicians and health care providers must be prepared to treat a culturally and economically diverse population.

But we also have to take personal responsibility for our health. Lifestyle choices are a critical part of the health equation. Medical care accounts for only 10 to 15 percent of preventable early deaths. Healthy eating, regular physical activity and stress management are essential. Moving from an approach to health that emphasizes sick-care to one that promotes wellness in schools, workplaces and communities will help kids and families stay healthy.

Policies and programs that address the environmental barriers to health are needed. Black and other underserved neighborhoods are less likely to have sidewalks, recreational facilities and green spaces that facilitate physical activity. Supermarkets and other sources of fresh fruits and vegetables are also noticeably absent in many black communities.

White neighborhoods are four times more likely to have a supermarket than black neighborhoods. Yet, the presence of supermarkets in black communities is associated with increased consumption of fruits and vegetables. Without access to healthy foods or neighborhood conditions that facilitate health, communities of color are at a severe disadvantage. Tax credits and other incentives can be used to stimulate investments in supermarkets, parks and further infrastructure development in underserved communities.